From Silence to Sound for a Child

"There is a ton of evidence that shows hearing loss is something we need to test for very [in very] young [children]. If we can find hearing loss before six months, we can get the hearing impaired to perform exactly the same as their peers for the rest of their life."
"It has a really big impact. Early is the key."
Marie Pigeon, senior audiologist, Children's Hospital of Eastern Ontario

"Seeing Francesca look up and smile at us as she hears our voices for the first time is the ultimate Christmas gift."
"We have so much to be thankful for this year."
William Jones, Baby Francesca's father

The day six-month-old Francesca’s cochlear implants were activated was magical for her parents, William Jones and Julia Tirabasso. SickKids

"Almost all the babies that I see who have congenital CMV, there is an older toddler at home who is in daycare. That is a very common presentation: The mom gets her primary infection through her older child who is in daycare and that is when it goes to the baby."
"I think a pregnant woman hears a lot of other messages in pregnancy: She is not supposed to change cat litter, she is not supposed to drink alcohol, she is not supposed to get influenza, but we don't talk that much about CMV prevention."
"I think as people become more aware of CMV and what it can do to babies through this hearing screening program we are going to have a better chance to teach women what they can do to prevent it in the first place."
Dr. Jason Brophy, pediatric infectious disease specialist, Children's Hospital of Eastern Ontario, Ottawa, Ontario

Francesca smiles at her parents, William and Julia, at her appointment at The Hospital for Sick Children (SickKids), where her cochlear implants were activated on December 10, 2018.

Between ten and fifteen percent of newborns show symptoms of congenital CMV at birth in Ontario. Yearly, roughly 925 babies are born with congenital CMV, in the province. One way to improve timeliness of treatment for infected infants, according to Dr. Pranesh Chakraborty, medical director of Newborn Screening Ontario, a pediatrician at CHEO, is the use of blood tests to screen for congenital CMV. A  new screening program based at CHEO proposes to identify children with hearing loss at an earlier, treatable stage.

The congenital infection can cause developmental delays in children. Babies born with congenital cytomgalovirus (cCMV) recognized as the commonest cause of non-hereditary hearing loss in children are now being routinely screened in a program the province of Ontario has adopted as one of the first jurisdictions in the world to enact a program of its kind. Newborn Screening Ontario has its base at the Children's Hospital of Eastern Ontario.

Six-month-old Francesca Jones was born with the CMV infection. The screening program revealed that infection, and as a result she has become the second-youngest infant to have received cochlear implants at Toronto's Hospital for Sick Children. The very day the implant surgery took place, the child's mother, Julia Tirabasso said to her daughter: "Ciao Francesca", and the baby responded with a big happy smile, the first time she had ever heard her mother's voice.

The purpose of the new screening program targeting newborns is meant to detect hearing loss in infants at as early a stage as possible to enable proper treatment and support for the child. When mothers during pregnancy are infected with congenital cytomegalovirus, a common virus, it can have devastating effects in some children. This common virus often has mild, or no symptoms whatever. By the time adulthood is reached between 50 and 70 percent of the general public have had CMV, and are immune to its effects.

But 40 percent of women who have never had the virus, then become infected while pregnant, will pass it on to the baby. Pregnant women, warned beforehand, can take preventive measures; for the most part that means avoiding mixing their saliva with that of their babies', as well as taking care to frequently wash hands. Pregnant mothers with toddlers are advised, stresses Dr. Brophy, to kiss their babies on the head, not the lips, and to wash their hands as often as possible.